Trouble At Home

Families Forced To Care For Youths With Mental Problems.

When one of them was able to sleep, they slid the dead bolt across their bedroom door.

They removed the knives, the sharp utensils, anything in their Hollywood home that could be used as a weapon.

What did they fear?

Their 14-year-old daughter, Shay.

The teen suffers from manic depression and was placed in several psychiatric institutions last year.

In November, the state said Shay had to live at home.

"She was out of control, and I was terrified," Judy Greth said.

More and more, emotionally and mentally disturbed children are being brought home and offered treatment there.

It's a lot cheaper than placing them in hospitals and it's a better solution for sick children, social workers say.

"The bottom line is locking kids up in hospitals doesn't work," said Kevin Huchshorn, supervisor for Broward mental health programs for children. "Many of the children placed in institutions for longer than a year end up in adult mental institutions. Or they get kicked out of child programs when they're 18 and end up on the street, in jail or in crisis units."

But the trend to keep disturbed youths home is getting mixed reviews from parents, judges and child advocates.

"What really ticks me off is when the state categorizes these kids, putting them in one group," Broward Circuit Judge Arthur Birken said. "In theory, if a family wants to work with a child at home, that's OK. But what about a kid who puts a gun to his mother's head? For better or worse, some kids need to be institutionalized."

Shay and her parents were one of the first families affected by the new trend in Broward County. When the teen-ager returned, she raged through the house, screaming and swearing at her parents. At one point, she threatened her mother's life.

"I begged the social workers not to do this," Judy Greth said. "They told me, `Secure your house.' I felt like a prisoner."

With the help of social workers, therapists and medication, Shay is learning to control her anger.

"It's still not great, but it's gotten a lot better," said Judy Greth, who quit her nursing job to care for her daughter.

Florida officials have long favored keeping children in their community rather than in institutions. But budget deficits in mental health programs during the past two years forced more communities to reduce the number of children sent away for treatment.

More than 275 troubled children in Florida are being treated in hospitals or centers.

Hospitalizing or placing a troubled youth in a treatment center costs $80,000 to $350,000 a year. Keeping one at home and offering therapy and counselors is far less expensive at $5,000 to $40,000 a year.

Broward faces a $1.7 million deficit in its mental health budget. Until the new state budget begins in July, the county has no more money to place children in treatment centers.

"The funding crunch is what forced us to look at another way," Huchshorn said. "But once we started exploring the issue, we realized we were far behind many other areas of the country in terms of developing community-based services."

The trend nationwide in the past decade has been to set up programs and resources for families with special-needs children.

"Institutions are not very good parents," said Barbara Huff of the Federation of Families, an advocacy group for families with emotionally disturbed children in Virginia. "Studies have shown that kids in hospitals were overmedicated and placed in restraints for days. It wasn't a good way to treat or help children."

While social workers think it's better to keep children at home and offer them therapy, not everybody is happy about Broward's change in philosophy.

Child advocates are concerned about keeping home children who have demonstrated violent or sexually aggressive behavior.

Judge Birken has difficulty believing the state has no money to treat youths like David. A month ago, David - whose real name is not being used because he is a juvenile - was placed in a psychiatric ward for evaluation.

David scaled the hospital's 16-foot fence and showed up at his mother's home. She called the police, and David fled.

Forty-eight hours later, David returned with a gun and threatened to kill his mother and siblings.